The census report came out yesterday, showing a distressing increase in the number of Americans without health insurance in 2009. There were50.7 million uninsured Americans in 2009, 15% of the population. The decrease in employer-based health insurance is even steeper than it appears, since the number of Americans on government insurance (Medicare, Medicaid and military) has grown sharply. The total number of insured Americans declined for the first decline since 1987, even while 5.7 million more Americans were on government insurance programs.

These numbers understate the magnitude of the transition in health insurance. For one thing, those who have insurance are likely to have less coverage than in previous years. Those with $1000 or greater annual deductibles doubled in the last year. Also, the census category of “government sponsored” insurance doesn’t include government employees. There are 2.5 million full time federal employees 3.8 million full time state employees 11.0 million full time local government employees Assuming that the full time governmental employees get their insurance from their employer, and that no part time employees get governmental insurance, the percentage of those with governmental insurance goes up from 28% to 33%. And that’s not counting another government health care expense -- the tax subsidy for employer-based health insurance, valued at $200 billion per year. Finally, last year those who had lost jobs were eligible for subsidies to purchase insurance (COBRA); these subsidies have since expired.

The rise in the uninsured makes controlling health care inflation even more important. Rising health care costs are directly associated with the rise in the number of uninsured. Support for health care reform in the US has declined . Support for universal health insurance could collapse altogether if we don’t rein in health care cost increases.